The prevalence of venous insufficiency in patients with chronic obstructive pulmonary disease evaluated by color duplex ultrasonography

Objectives: We hypothesized that in patients with chronic obstructive pulmonary disease (COPD) some extrapulmonary effects such as increase in intra-abdominal and intra-thoracic pressures, presence of cor pulmonale and pulmonary artery hypertension could cause venous insufficiency (VI) in the lower limbs. Our aim in this study was to assess the prevalence of VI in patients with COPD in comparison with healthy controls. Methods: Thirty-nine male patients with COPD and 36 healthy male controls were evaluated for VI. All the participants were in the same age group and their smoking intensities were similar. Patients with COPD were classified as having mild, moderate, severe or very severe disease according to criteria of the Global Initiative for Chronic Obstructive Lung Disease. All the patients and control group were examined for unilateral or bilateral VI of the common femoral vein, superficial femoral vein, deep femoral vein and popliteal vein using color duplex ultrasonography. Results: The prevalence of VI of the lower extremity in patients with COPD (69.2%) was significantly higher than in the healthy control group (41.7%). The prevalence increased as the COPD severity increased and VI was detected in all the patients with very severe COPD [mild COPD, 50.0% (2/4); moderate, 58.8% (10/17); severe, 75.0% (9/12); very severe, 100% (6/6)]. Conclusion: VI of the lower extremity appears more frequent in patients with COPD. We suggest ruling out COPD in patients with otherwise unexplained "primary" VI.